State Hospitals Bear 87% of Patients but Receive Only 64% of Gold Card Funding
State hospitals treat 87% of gold card patients but receive only 64% of funding, creating a severe budget shortfall as private providers get four times more per capita, prompting a review of allocation criteria.
On August 3, Dr. Suphachoke Wetchaphun, head of the Public Health Ministry's inspection unit, disclosed a critical imbalance in gold card funding distribution. State hospitals currently face revenue shortfalls compared to expenses due to rising costs for medications, medical supplies, and non-tenured staff salaries. In fiscal year 2568, hospitals received 246.9 billion baht from non-budgetary sources, with 107.7 billion baht (43.6%) coming from the 30-baht gold card scheme.
Dr. Suphachoke noted that the National Health Security Office allocated 168.3 billion baht in fiscal 2568 for 47.15 million gold card holders, averaging 3,856 baht per person. However, state hospitals caring for 41.13 million beneficiaries (87% of the total) received only 107.7 billion baht (64% of total funding), translating to 2,618 baht per person. Meanwhile, other providers—private hospitals, university hospitals, and local health organizations—serve only 13% of patients but receive 60.6 billion baht (36% of funds), averaging 10,063 baht per person, four times higher.
Further analysis reveals that from 2565 to the present, per-capita basic service funding increased by only 26%, while targeted health activity budgets climbed 71%. Dr. Somruk Choksomboon, Public Health Permanent Secretary, proposed reviewing allocation criteria to align funding with actual service burdens and populations served, particularly for specialized programs like HIV treatment funds, ensuring equitable care quality nationwide.